gp130 is important for the normal morphogenesis of Meckel's cartilage and subsequent mandibular development

gp130-mediated signaling is involved in both chondrogenesis and osteogenesis, but its direct role in the formation of embryonic Meckel's cartilage and associated mandibular development has not yet been elucidated. In this study, we examined the influence of gp130 ablation on the developing mandibular Meckel's cartilage by evaluating the morphological and histological changes as well as the gene expression patterns in developing embryonic gp130-/- mice. The ablation of the gp130 gene showed no change in region-specific collagen mRNA expression except for a slight delay in its expression but caused shortened embryonic Meckel's cartilage, delayed hypertrophic chondrocyte maturation and subsequent bony replacement with characteristic bending of the intramandibular Meckel's cartilage. The bending of Meckel's cartilage led to a narrow mandibular arch at the rostral area with poor cortical plate formation. These findings indicate that gp130-mediated signaling is important for the normal morphogenesis of Meckel's cartilage and subsequent mandibular development.

A Case of Ruptured Abdominal Pregnancy Associated with Endometriosis / 대한산부인과학회잡지

Abdominal pregnancy is a rare form of extrauterine pregnancy which is account for 1.4% of all ectopic pregnancy cases. Among these omental pregnancy is extremely rare and may cause life-threatening massive hemorrhage as a complication. But the diagnosis of early abdominal pregnancy is difficult because of non specific findings about clinical history, physical examination and ultrasonography. Risk factors related to ectopic pregnancy include inflammation, infection and surgery, but endometriosis is an uncommon factor. We present a case of the ruptured primary omental pregnancy associated with endometriosis with a review of the literature.

A Case of Torsed Voluminous Parovarian Cyst / 대한산부인과학회잡지

Parovarian cysts constitute 10% of adnexal masses. They were found in broad ligament and mostly arise from mesothelium and less commonly from paramesonephric element and rarely from mesonephric element. In most cases parovarian cysts were asymptomatic. So, they were found incidentally at surgery for other conditions. Torsion is infrequent and it is difficult to distinguish it from torsion of other adnexal masses, appendicitis, etc. Recently, we experienced a voluminous parovarian cyst undergoing torsion, 25 cm in diameter. The case is presented with a review of literature.

A Case of Huge Condyloma Acuminatum During Pregnancy / 대한산부인과학회잡지

Condyloma acuminatum is a manifestation of human papillomavirus (HPV) infection. The genital warts tend to occur in areas most directly affected by coitus, namely external genitalia, perineum and perianal areas. The warts are highly contagious; more than 75% of sexual partners develop when exposed. The warts frequently increase in number and size during pregnancy, sometimes filling the vagina or covering the perineum, making it difficult to perform vaginal delivery or episiotomy. Probably small number of infants and children born of women with genital warts will become infected and develop laryngeal papillomatosis. We have experienced one case of huge condyloma acuminatum during pregnancy and presented with a brief review of literature.

A Case of Blue Nevus of the Uterine Cervix / 대한산부인과학회잡지

Blue nevus of the uterine cervix is a rare benign pigmented lesion consisting of dermal melanocytes in the stroma. It is similar to those of common blue nevus of the skin. Most of these are clinically or colposcopically unsuspected and an incidental finding often found in hysterectomy specimens. The case here was incidentally found in surgical pieces after hysterectomy in 43-year-old women performed for leiomyoma. We report a case of blue nevus of the uterine cervix with a review of the literature.

Seroepidemiologic Study of Measles Outbreak in a Primary School, Youngduk / 감염과화학요법

BACKGROUND: Nation-wide measles outbreaks occurred from 2000 to 2001 in Korea. Since, mass vaccination campaign for measles eradication among children and adolescents was implemented in May-August of 2001. Even in a highly vaccinated community, measles cases occur among vaccinees and there might be different serological responses among unvaccinees. In addition, the primary and secondary vaccine failures are not rare in the mass-vaccination era. Therefore, this study was undertaken to evaluate the effectiveness of serologic method for diagnosis of measles among the vaccinees and to estimate the vaccine failure rate among students with relatively high vaccination rate during the measles outbreak in a primary school. METHODS: In March 2000, the measles outbreak occurred in a primary school in Youngduk county, Kyung-sang-buk Do. Questionnaires about clinical manifestations of measles and history of measles vaccination were given out to in 209 3rd and 5th grade students among whom many measles cases occurred. The paired sera, which were taken from all students during March and May 2000, were tested for IgM and IgG measles antibody by using Enzygnost Anti-Measles IgG and IgM (Dade Behring, Germany). RESULTS: The questionnaires and serum samples were obtained from 145(69.4%) out of 209 cases. The immunization rate of measles vaccine was 80.7% (117/145). During the measles outbreak, 25 (17.2%) out of 145 cases with previous history of measles vaccination were diagnosed as measles, based on clinical definition. Among 17 cases (17/25, 68.0%) with paired samples out of 25 measles cases, 4 cases (4/17, 23.5%) were diagnosed by seroconversion of IgG, but negative IgM antibody, and they all had received measles vaccination previously. Among 117 cases with previous history of measles vaccination, 47 (40.2%) cases without measles symptoms showed four-fold increment of IgG titer. The primary and secondary failure rates of measles vaccine were 6.0% (7/117) and 1.7% (2/117), respectively. CONCLUSION: Among symptomatic measles cases with previous history of measles vaccination, 23.5% were diagnosed only by seroconversion of IgG measles antibody. In a highly vaccinated country, the accuracy of measles serodiagnosis can be increased with the IgG test of convalescent serum sample in addition to IgM antibody test. Among vaccinees, secondary immune response was 40.2%, suggesting that non-specific measles symptoms might occur among them. Therefore, further studies on the clinical definition of measles cases, vaccine failure rate and protective antibody titers should be continued in order to effectively conduct measles eradication campaign.

Seroepidemiologic Study of Measles Outbreak in a Primary School, Youngduk / 감염과화학요법

BACKGROUND: Nation-wide measles outbreaks occurred from 2000 to 2001 in Korea. Since, mass vaccination campaign for measles eradication among children and adolescents was implemented in May-August of 2001. Even in a highly vaccinated community, measles cases occur among vaccinees and there might be different serological responses among unvaccinees. In addition, the primary and secondary vaccine failures are not rare in the mass-vaccination era. Therefore, this study was undertaken to evaluate the effectiveness of serologic method for diagnosis of measles among the vaccinees and to estimate the vaccine failure rate among students with relatively high vaccination rate during the measles outbreak in a primary school. METHODS: In March 2000, the measles outbreak occurred in a primary school in Youngduk county, Kyung-sang-buk Do. Questionnaires about clinical manifestations of measles and history of measles vaccination were given out to in 209 3rd and 5th grade students among whom many measles cases occurred. The paired sera, which were taken from all students during March and May 2000, were tested for IgM and IgG measles antibody by using Enzygnost Anti-Measles IgG and IgM (Dade Behring, Germany). RESULTS: The questionnaires and serum samples were obtained from 145(69.4%) out of 209 cases. The immunization rate of measles vaccine was 80.7% (117/145). During the measles outbreak, 25 (17.2%) out of 145 cases with previous history of measles vaccination were diagnosed as measles, based on clinical definition. Among 17 cases (17/25, 68.0%) with paired samples out of 25 measles cases, 4 cases (4/17, 23.5%) were diagnosed by seroconversion of IgG, but negative IgM antibody, and they all had received measles vaccination previously. Among 117 cases with previous history of measles vaccination, 47 (40.2%) cases without measles symptoms showed four-fold increment of IgG titer. The primary and secondary failure rates of measles vaccine were 6.0% (7/117) and 1.7% (2/117), respectively. CONCLUSION: Among symptomatic measles cases with previous history of measles vaccination, 23.5% were diagnosed only by seroconversion of IgG measles antibody. In a highly vaccinated country, the accuracy of measles serodiagnosis can be increased with the IgG test of convalescent serum sample in addition to IgM antibody test. Among vaccinees, secondary immune response was 40.2%, suggesting that non-specific measles symptoms might occur among them. Therefore, further studies on the clinical definition of measles cases, vaccine failure rate and protective antibody titers should be continued in order to effectively conduct measles eradication campaign.

A case of conservative management of cervical pregnancy using selective uterine artery embolization / 대한산부인과학회잡지

Cervical pregnancy is a rarely life-threatening form of ectopic pregnancy in which the implantation of the developing conceptus in the cervical canal. The cervix is composed predominantly of the fibrous tissue. Therefore cervical pregnancy can be massive hemorrhagic occurrence from the eroded blood vessels within the cervical tissue. In the past, as a result of life-threatening hemorrhage, the diagnosis of a cervical ectopic pregnancy frequently led to hysterectomy. Currently, several conservative treatments are possible with the hope of preserving future reproductive potential, including preoperative uterine artery embolization before dilatation and evacuation. We report a case of cervical pregnancy which was treated sucessfully with preoperative selective uterine artery embolization before dilatation and currettage.

Clinical Review of 'Tension Free' Inguinal Hernioplasty with Polypropylene Mesh and Bassini Type Inguinal Hernioplasty

BACKGROUND: All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and account for an unacceptable number of failures. Total reinforcement of the inguinal floor with a sheet of suitable biomaterial of a 'tension-free' technique is a more effective approach. METHODS: We have treated inguinal hernias by Bassini method in eighty-nine patients and by Lichtenstein tension free method in sixty-one patients from September, 1993 through December, 1995 and compared these two groups on age, sex, site, type anesthesia, operation time, admission date, postoperative complication, postoperative pain-killer injection period, recurrence. RESULTS: The result are as follows 1) There was no significantly difference compared Bassini method with Lichtenstein tension free method on age, sex, site, type, anesthesia, postoperative complications. 2) The average time of operation was 61.8 minutes on Bassini method and 53.6 minutes on Lichtenstein tension free method. 3) The postoperative complications were hematoma 2 cases, wound seroma 1 case on Bassini method, and wound seroma 1 case on Lichtenstein tension free method. 4) The average duration in the hospital stay after operation was 6.01 days on Bassini method and 4.75 days on Lichtenstein tension free method (p<0.01). 5) The average period for injection of pain-killer after operation was 3.61 days on Bassini method and 2.21 days on Lichtenstein tension free method (p<0.01). 6) The recurrence rate was 6 cases(6.7%) on Bassini method and no recurrence case on Lichtenstein tension free method (p<0.05). CONCLUSIONS: We conclude that Lichtenstein tension free method is less painful and shorter postoperative hospital stay than Bassini method.

Closed Reduction of Mallet Fractures using Extension Black Kirshner Wire / 대한정형외과학회잡지

Operative repair of mallet fracture is a technically difficult operation because fracture of fragment and the difficulty in visualizing the articular congruity. The problems with these methods include soft tissue scar formation and subsequent joint stiffness. From January 1993 to April 1994, eight cases of mallet fingers with displaced large fracture fragment and/or subluxed distal phalanx were treated by closed reduction using extension-block Kirschner wire. The follow-up evaluation took place after a mean of 6 months. The results according to Crawford's criteria were four excellent, two good and two fair. This technique is simple, and easier than other techniques for reduction of mallet fractures, and is associated with a low morbidity.